ROLE OF THE PHARMACIST IN SERVICE-LINE DEVELOPMENT AND MANAGEMENT

To recognize pharmacists bring unique clinical, operational, and financial expertise to help organizations develop and manage high-value health-system service lines; further,

To support the role of pharmacy leadership in the development and management of high-value health-system service lines.

Rationale

To drive success in the current market, health systems, especially those within integrated delivery networks, must optimize growth by applying strong tactics to acquire and retain patients. Service-line development is structuring patient-centered care in clinically specific areas across the healthcare system. Service-line design groups patients into specific areas of need, improving care coordination and accountability and allowing for a nimble response to changes (e.g., in the allocation of resources).

Pharmacists bring clinical, operational, and financial expertise to help organizations (1) optimize resources, (2) ensure safe medication use and patient-centric system design, (3) drive patient and provider satisfaction, (4) improve patient outcomes, and (5) achieve financial growth when part of critical decision-making for setting an organization’s overall service-line growth and management strategy. For example, pharmacists working as part of a specialty pharmacy can leverage their expertise to assess a certain population within a service line, with the goal of improving care and patient safety while promoting use of cost-effective treatments. Most specialty pharmacies allow pharmacists to oversee financial, operational, and clinical services, which has led to growth in patient access and revenue for health systems. Health systems can reap many benefits from expanding service lines, including increased patient volumes, improved health outcomes, boosted market share, and improved patient and provider satisfaction. By focusing on developing high-value service lines, health systems have the opportunity to achieve financial growth and significant return on investment. Growing high-value service lines is one of the most effective ways in which hospitals and health systems can add value to the healthcare system. Growing service lines requires careful strategic planning, and success hinges on an organization’s proficiency in (1) understanding and predicting patient needs; (2) acquiring commercial health plans; (3) using an omni-channel approach; (4) focusing on provider referrals; (5) safe medication use and patient-centric system design (e.g., medication stewardship, formulary alignment, medication-use policies); and (6) ensuring the C-suite is fully committed to the service-line development strategy. High-value service lines exemplify exceptional performance in many ways, including attracting the most patients and providers, driving the most revenue, achieving the highest care success rates, and presenting the greatest growth potential. Healthcare organizations identify their high-value service lines by analyzing financial data, external market factors (e.g., value-based contracts), and other relevant economic conditions. Data analytics and effective patient communication are important when healthcare organizations are working to grow service lines. High-value service lines may differ among hospitals, depending on the patients and markets they serve. During times of scarce capital and growing demand for services, service-line analysis becomes a high-priority task for hospital and health-system decision-makers. Leaders must face hard questions when it comes to identifying the areas of operations critical to an institution’s long-term financial viability and should ensure those service lines get the investment and management attention they need. Service-line analysis may also mean eliminating low-volume and/or unprofitable service lines that drain resources. Before hospital leaders decide to discontinue a given service line, they should consider whether the line has been properly managed. Many hospitals may have inadvertently harmed service-line management by not investing sufficiently in the resources needed for success.

In today’s environment, successful service-line development efforts need input from pharmacy leaders from the outset of discussions through implementation and management. Engagement in every step of service-line development and management assures long-term success as strategic direction is set. Success as a pharmacy leader is predicated on building and maintaining relationships with diverse groups of people in order to be part of setting the overall strategy for an organization. This relationship-building may include partnering with nontraditional healthcare participants to develop new strategies for care. As healthcare markets continue to shift away from volume and toward value, appealing to patients by building high-value service lines designed to meet patients’ unique needs will become increasingly important.